We are a comprehensive, full service out-of-network revenue management solutions company that maximizes reimbursements exclusively for out-of-network surgical specialists.
Our team, led by Leslie Howard, CEO are experts in physician billing and coding, ERISA, appeals, commercial insurance, and State & Federal surprise billing regulations. We have a methodical yet customized process to persistently pursue payments from commercial payors by exploring all viable pathways to maximize reimbursements from the very start of the claim management cycle and by leveraging our ability to craft unique strategies on a claim-by-claim basis to increase your practice’s revenue.
With virtually all out-of-network claims potentially being subject to time sensitive state and/or federal surprise bill regulation, having an in-depth understanding of how the rules impact payment is critical – we provide an enhanced approach to protect a provider’s right to pursue fair payment at every step along the way.
Preservice authorizations such as a GAP/Single Case Agreement (SCA) can be advantageous in certain circumstances with proper documentation. There are many strategies and tools to employ to maximize reimbursements and our team has in-depth knowledge to execute our sophisticated strategies to achieve the best possible outcome for your practice.
Understanding the “True Maximum Value” of a claim is predicated on a variety of factors such as multiple procedure reductions (MPRs). Our company has a proprietary database with payor payment data for all specialties across the country that can be leveraged for negotiations, and through our affiliate law firm Cohen Howard, utilized for arbitrations, and litigation, if necessary, all managed under one partner, CH Revenue Management Solutions.
We believe providers engaging in our full suite of services have a strategic advantage with a partner that is focused on protecting providers rights to pursue maximum payment from the very start of the revenue cycle management process through the multiple pathways that a claim may take.